Healthcare Provider Details

I. General information

NPI: 1134921166
Provider Name (Legal Business Name): AVANTA CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2025
Last Update Date: 07/30/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

483 OAK DR
HAPEVILLE GA
30354-1228
US

IV. Provider business mailing address

483 OAK DR
HAPEVILLE GA
30354-1228
US

V. Phone/Fax

Practice location:
  • Phone: 404-464-6700
  • Fax: 404-738-3377
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MELISSA SIMMS
Title or Position: CEO
Credential:
Phone: 404-464-6700